参考文献(No. 61〜69)
No. 61
[PubMed]
Patterns of facial resuscitation injury in infancy.
Kaplan JA, Fossum RM
Office of the Chief Medical Examiner, Concord, NH 03301.
Cardiopulmonary resuscitation (CPR)-related artifacts in pediatric rescue that
have the potential for serious complications in surviving patients have been
well described in the medical literature. Medically trivial soft-tissue
injuries, especially of the face and neck, carry predominantly forensic
significance and have received less attention. We describe such injuries in
nine
of 25 consecutive cases of infants who received CPR, and correlate those
injuries with specific rescue maneuvers. Techniques for effective investigation
and interpretation of such injuries are suggested.
PMID: 7825546, UI: 95126080
No. 62
[PubMed]
Child abuse, cardiopulmonary resuscitation, and rib fractures.
Feldman KW, Brewer DK
Rib fractures have occasionally been described in children receiving
cardiopulmonary resuscitation (CPR). Because child abuse is sometimes suspected
in these cases, it is both medically and legally important to establish whether
the rib fractures are secondary to abuse or CPR. One hundred thirteen children,
including 41 victims of child abuse, 50 patients who had CPR, and 22 patients
who had rib fractures, were studied. Twenty-nine patients had rib fractures;
14/29 (48%) were abusive. Other causes of fracture were: motor vehicle
accidents
(four), rickets/osteoporosis (five), surgery (five), and osteogenesis
imperfecta
(one). In spite of prolonged resuscitation performed with variable degrees of
skill, no fractures could be attributed to CPR. On the other hand, rib
fractures
occurred frequently in abused children (6/41 or 15%). Abusive fractures were
often multiple, of different ages, and affected multiple adjacent ribs.
Patients
with abusive rib fracture also had other physical and radiologic signs of abuse
or neglect.
PMID: 6701057, UI: 84143903
No. 63
[PubMed]
Complications of CPR.
Nagel EL, Fine EG, Krischer JP, Davis JH
PMID: 7214982, UI: 81163650
No. 64
[PubMed]
Cardiopulmonary resuscitation-related injuries.
Powner DJ, Holcombe PA, Mello LA
PMID: 6690207, UI: 84083368
No. 65
[PubMed]
Unexplained pneumoperitoneum in association with basic cardiopulmonary
resuscitation efforts.
Parke TR
Glasgow Royal Infirmary, UK.
During the mouth to mouth ventilation of basic life support, the high inflation
pressures generated may result in later complications. Pulmonary barotrauma may
result in pneumothorax or pneumomediastinum, and high pressures applied to the
gastrointestinal tract may lead to gastric rupture and pneumoperitoneum. A case
is reported of pneumoperitoneum in the absence of pneumothorax,
pneumomediastinum or gastrointestinal perforation and the literature
relating to
this unusual condition is reviewed.
PMID: 8290812, UI: 94120199
No. 66
[PubMed]
Retinal hemorrhages following cardiopulmonary resuscitation.
Kramer K, Goldstein B
Department of Pediatrics, University of Rochester Medical Center, NY 14642.
PMID: 8393755, UI: 93345187
No. 67
[PubMed]
Cardiopulmonary resuscitation in the delivery room. Associated clinical events.
Perlman JM, Risser R
Department of Pediatrics, University of Texas Southerwestern Medical Center,
Dallas.
DESIGN: Observational study.
SETTING: Urban
county hospital. RESULTS: For 2 years, 39 (0.12%) of 30,839 infants were
administered chest compressions and/or epinephrine as part of cardiopulmonary
resuscitation in the delivery room. Fifteen were term infants and 24 were
premature. Five term infants had evidence of severe fetal acidemia (FA)
(umbilical cord arterial pH < 7.00 and/or base deficit > or = -14 mEq/L); two
died secondary to severe brain injury, and the neurologic examinations showed
abnormalities in the three survivors. The 10 infants without severe FA
exhibited
an uncomplicated neonatal course. Five infants had evidence of severe FA; the
neurologic examination showed abnormalities in four. Of the remaining 19
infants
without severe FA, four died and five additional infants have moderate to
severe
brain injury. Abnormal outcome was more likely to occur with severe FA (P <
.002). The presumed clinical events contributing to the neonatal depression
were
severe FA (n = 10), malpositioning of the endotracheal tube (n = 5), and
ineffective or improper initial ventilatory support (n = 24). CONCLUSIONS:
Cardiopulmonary resuscitation in the delivery room, resulting in administration
of chest compressions and medications, is a rare event. Approximately one third
of the infants had evidence of severe FA; in the remaining two thirds,
ineffective or improper initial ventilatory support was the presumed mechanism
for the continued neonatal depression. The appropriate therapeutic response to
continuing neonatal depression should be to optimize ventilatory support before
administering chest compressions or medications.
PMID: 7827654, UI: 95128387
No. 68
[PubMed]
Age-related changes in chest geometry during cardiopulmonary resuscitation.
Dean JM, Koehler RC, Schleien CL, Michael JR, Chantarojanasiri T, Rogers MC,
Traystman RJ
We studied alterations of chest geometry during conventional cardiopulmonary
resuscitation in anesthetized immature swine. Pulsatile force was applied to
the
sternum in increments to determine the effects of increasing compression on
chest geometry and intrathoracic vascular pressures. In 2-wk- and 1-mo-old
piglets, permanent changes in chest shape developed due to incomplete recoil of
the chest along the anteroposterior axis, and large intrathoracic vascular
pressures were generated. In 3-mo-old animals, permanent chest deformity did
not
develop, and large intrathoracic vascular pressures were not produced. We
propose a theoretical model of the chest as an elliptic cylinder. Pulsatile
displacement along the minor axis of an ellipse produces a greater decrease in
cross-sectional area than displacement of a circular cross section. As thoracic
cross section became less circular due to deformity, greater changes in
thoracic
volume, and hence pressure, were produced. With extreme deformity at high
force,
pulsatile displacement became limited, diminishing pressure generation. We
conclude that changes in chest geometry are important in producing
intrathoracic
intravascular pressure during conventional cardiopulmonary resuscitation in
piglets.
PMID: 3610916, UI: 87279663
No. 69
[PubMed]
Proceedings of the Second Chicago Symposium on Advances in CPR Research and
guidelines for laboratory research: foreword.
Becker BL, Idris AH
Section of Emergency Medicine, University of Chicago Hospital, Illinois, USA.
Publication Types: Congresses
PMID: 8629773, UI: 96211824
OBJECTIVES: To determine (1) what percentage of infants require chest
compressions and medications as part of resuscitation in the delivery room, (2)
the associated clinical events contributing to neonatal depression, and (3) the
neonatal outcome of such children.
(小児の心肺蘇生法)